Treatment with tumor necrosis factor inhibitors (TNFis) is not associated with increased risk for cancer recurrence in patients with rheumatoid arthritis (RA), according to data published in the Annals of Internal Medicine.

Researchers conducted a population-based cohort study to investigate whether TNFi treatment in RA is associated with increased risk for cancer recurrence. A total of 467 patients who initiated TNFi treatment after being diagnosed with cancer were included in the study, with a mean time after cancer diagnosis of 7.9 years. Investigators also identified a matched cohort of 2164 patients with the same cancer history who had never received biologics.

Results showed that 9.0% of participants who received TNFis experienced cancer recurrences (mean follow-up, 5.3 years) compared with 7.2% of participants who had never received biologics (mean follow-up, 4.3 years), resulting in a hazard ratio of 1.06 (95% CI, 0.73-1.54).

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The investigators also conducted an unmatched analysis including 3826 patients with RA who had a history of cancer but no history of biologic treatment. Of 178 participants who initiated TNFis, 9% had a cancer recurrence during follow-up (adjusted hazard ratio, 1.24; 95% CI, 0.74-2.07).

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“Our results should be interpreted in light of the treatment channeling that is part of clinical practice and may not be directly applicable to patients with ongoing cancer or a recent cancer diagnosis or to all cancer types,” the authors concluded.


Raaschou P, Soderling J, Turesson C, Askling J. Tumor necrosis factor inhibitors and cancer recurrence in Swedish patients with rheumatoid arthritis [published online August 13, 2018]. Ann Intern Med. doi: 10.7326/M17-2812